Communicating bad news, Stillbirth, Fatal fetal abnormality,
Objective Communicating bad news in an obstetric setting is challenging for both clinicians and parents. This study explores the impact of bad news on parents diagnosed with stillbirth or fatal fetal abnormality who were cared for in an Irish tertiary maternity hospital (8,500 births per annum) where the perinatal mortality rate is 5.2/1000.
Study design Semi-structured qualitative interviews lasting 31–104 minutes were conducted with 12 mothers and 5 fathers following ante-natal bereavement. The participants were purposively sampled from each of the years 2008, 2010 and 2013. The data were analysed using Interpretative Phenomenological Analysis.
Results The diagnosis of a fatal fetal abnormality or confirmed stillbirth had a profound and enduring impact on each of the parents interviewed. The data revealed a forensic recollection of the context of how news was communicated. Diversionary techniques while awaiting another opinion to confirm a diagnosis were identified by parents. These interactions resulted in a sense of mistrust when it was felt information was purposefully withheld. The remaining major themes were: language used, timing and sensitivity. How and where bad news was communicated had a considerable impact on parents.
Conclusion How professionals communicate bad news to parents is remembered in painstaking detail, often revisited as parents seek to understand their loss. This study reveals in parents’ own words examples of how and how not to break bad news. These findings are of interest to clinicians, sonographers and midwives as they continue to refine communication skills in one of the most challenging areas of obstetric practice.